Evaluación de las habilidades clínicas de lactancia materna entre los estudiantes de enfermería utilizando el Examen Clínico Objetivo Estructurado (ECOE)

Natalia Villegas; Rosina Cianelli; Madeline Fernandez; Shakira Henderson; Solange Sierra; Yarilys Alfonso; Crystal Jackson

doi:10.1016/j.riem.2016.04.001

DOI: https://doi.org/10.1016/j.riem.2016.04.001

Natalia Villegas
Rosina Cianelli
Madeline Fernandez
Shakira Henderson
Solange Sierra
Yarilys Alfonso
Crystal Jackson

Abstract

Introduction: Insufficient education and training in nursing programs has led to nurses in the field knowing very little in order to assist a breastfeeding mother. Several studies recommend implementation of effective breastfeeding training in all undergraduate curricula that lead to nursing and other healthcare degrees.

Objective: To analyze the development of an objective structured clinical examination (OSCE) to measure breastfeeding clinical skills and the preliminary outcomes of its implementation.

Method: Participants for this pilot study were 23 undergraduate nursing students. The breastfeeding OSCE consisted of 10 stations where students performed different clinical skills under a simulated environment. The clinical skills being assessed in each station ranged from performing proper manual milk expression to correctly using a breast pump on a mannequin’s breast. Observers in each station completed a checklist which assessed each student’s clinical ability to complete that task correctly. Students conducted an evaluation of the training immediately after completing the OSCE using a structured online questionnaire.

Results: The stations with the highest score were: interventions for sore, leaking, and inverted nipples (station 4, M = 2.57, SD = .843, range 1---3) and indicators of adequate latching (station 6; M = 7.09, SD = 1.443, range 4---8). The stations with the lowest scores were: pump set up to breast and how to remove the infant from the breast (station 1, M = 7.96, SD = 1.745, range 4---10), and breastfeeding positions (station 5, M = 1.65, SD = .714, range 0---2).

Conclusion: The OSCE has been positively evaluated for objectivity in student assessment and provides a ‘hands on’ approach to assessing clinical competence. Scores and student feedback suggests that the OSCE can be a valuable tool to be used in courses of any nursing or healthrelated undergraduate curriculum.